Revenue Cycle Representative (Provider Enrollment) - Training, Operations, and Administrative Support (TOAST) - Patient Financial Services (PFS)

University of Iowa•Iowa City, IA

3d•Hybrid

About The Position

University of Iowa Health Care’s Patient Financial Services department is hiring a Revenue Cycle Representative for provider enrollment within the Training, Operations, and Administrative Support division. The role supports revenue cycle operations by coordinating, maintaining, and managing provider enrollment activities with Medicare, Medicaid, and other payer programs. It maintains accurate enrollment records and supports compliance with payer and regulatory requirements, uninterrupted billing, and reimbursement. The position works with providers, government payer representatives, vendors, and internal stakeholders to complete enrollment activities and resolve complex issues, applying established tools and operational knowledge with sound judgment, professionalism, integrity, and a commitment to UI Health Care’s Service Excellence standards. The position is eligible for a hybrid work arrangement involving onsite and remote work. Remote work must take place at an approved location within Iowa. Initial training is conducted onsite at the Health Support Services Building or virtually, as determined by Patient Financial Services leadership. Remote-work eligibility is assessed after successful completion of training and satisfactory job performance. Work arrangements are subject to annual review and applicable University policies. The schedule is Monday through Friday, 0800–1700, and the position is listed at 100% time. The department provides onsite workstation equipment. For offsite work, the employee must provide two monitors, a keyboard, and a mouse at their own expense; other equipment and setup requirements are specified in the posting. The employer is University of Iowa Health Care, a comprehensive academic medical center and regional referral center.

Requirements

Bachelor’s degree or an equivalent combination of education and experience.
At least one year of experience in a professional, healthcare, revenue cycle, provider enrollment, credentialing, insurance, compliance, or related administrative environment.
Strong attention to detail and demonstrated ability to analyze information, maintain accurate records, identify discrepancies, and ensure data integrity across multiple systems and databases.
Critical-thinking and problem-solving skills, including the ability to research, interpret, and resolve complex enrollment, billing, or payer-related issues with minimal supervision.
Proficiency with Microsoft Office applications, including Excel, Word, Outlook, and Teams, and ability to learn and apply new software applications and payer systems.
Ability to prioritize work, manage multiple deadlines, and adapt to changing operational needs while maintaining accuracy and productivity.
Strong verbal, written, and interpersonal communication skills and ability to collaborate effectively with providers, leadership, payers, vendors, and internal stakeholders.
Professionalism, initiative, sound judgment, and commitment to high-quality customer service and support in a complex healthcare environment.

Nice To Haves

Experience with provider enrollment, credentialing, payer contracting support, provider data management, or related healthcare administrative functions.
Knowledge of Medicare, Medicaid, National Provider Identifier requirements, provider enrollment regulations, and provider enrollment processes.
Knowledge of healthcare revenue cycle operations, medical billing, insurance reimbursement, and claims processing.
Experience researching and resolving payer enrollment issues, claim denials, reimbursement delays, or provider data discrepancies.
Experience maintaining productivity and quality standards in a high-volume, deadline-driven environment.
Knowledge of medical terminology, HIPAA requirements, and healthcare regulatory standards.
Experience using Epic, CredentialStream, payer portals, or other healthcare enrollment, credentialing, and patient accounting systems.
Knowledge of Patient Financial Services operations, workflows, and healthcare reimbursement practices.

Responsibilities

Coordinate and manage provider enrollment activities for Medicare, Railroad Medicare, Iowa Medicaid, and other assigned payer programs, including initial enrollments, updates, revalidations, reassignments, terminations, acquisitions, and practice relocations.
Maintain accurate provider records in enrollment databases, payer systems, the NPI Registry, and other organizational applications to meet payer requirements and support billing and reimbursement.
Prepare, submit, track, and maintain enrollment applications and supporting documentation; monitor enrollment status and resolve issues that may affect provider participation or claims processing.
Review, investigate, and resolve enrollment-related claim edits, denials, enrollment discrepancies, and reimbursement issues in collaboration with providers, payer representatives, vendors, and internal stakeholders.
Coordinate enrollment activities with providers, clinical departments, the Clinical Staff Office, Patient Financial Services leadership and staff, external vendors, and payer contacts.
Maintain and audit enrollment-related records, reports, work queues, and vendor activities for accuracy, completeness, regulatory compliance, and departmental quality standards.
Develop, maintain, and distribute provider enrollment resources, documentation, and communications.
Monitor correspondence, email communications, and enrollment notifications and ensure timely review, response, and processing.
Analyze trends, identify process-improvement opportunities, and recommend ways to improve operational efficiency, enrollment accuracy, compliance, and revenue cycle performance.
Support departmental initiatives and special projects while maintaining accuracy, productivity, professionalism, and service excellence.
Protect the confidentiality of provider, patient, employee, financial, and organizational information in accordance with applicable laws, regulations, and policies.